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"Pendahuluan: nitrogen oksida menginduksi relaksasi otot polos dan menyebabkan peningkatan guanosisn monofosfat siklik (cGMP) dalam otot polos. Peningkatan ini terjadi melalui perangsangan guanilat sikiase. Sildenafil adalah penghambat cGMP-fosfodiesterase tipe V (PDE V) yang poten dan selektif. Yang merupakan isoenzim pemetabolis cGMP dalam korpus kavernsosum. cGMP adalah messenger nitrogen oksida kedua dan mediator utama relaksasi dan vasodilasi otot polos dalam penis.Tujuan : penelitian ini bertujuan untuk membandingkan efikasi antara donor oksda nitrat, inhibitor spesifik PDE V dengan kombinasinya terhadap relaksasi korpus kavernosum kelinci. Lembaran korpus kavernosum keilnci yang diisolasi dirangsang secara isosimetris dengan fenilefrin. Relakasasi bertingkat diinduksi dengan menggunakan berbagai konsentrasi S-Nitroso-N-asetilpenisilamin (SNAP) sildenafil sitrat dan kombinasinya. Signifikansi statistik diuji melalui analisis varian satu arah (ANOVA) dan jika ada perbedaan bermakna diantara reratanya, uji akan dilanjutkan dengan komparasi multipel Benferroni.Hasil: pada 10-8 M, SNAP, sildenafil sitrat dan kombinasinya merelaksasi preparat, secara berurutan sebesar 29 + 4.8%, 46 ± 2.5%, and 36 ± 3.9%. Perbedaan ini signifikan dengan uji analisis varian (p<0.05). Hasil yang sama ditemukan pada konsentrasi 10-1M, 10-8M, and 10-5M. Dad uji komparasi Benferroni, diketahui pada konsentrasi 10'aM, 10-7M, and10-6M sildenafil sitrat dapat merelaksasi korpus kavernosum lebih besar dibandingkan dengan SNAP (p<0.05) dan tidak ada perbedaan bermakna antara sildenafil sitrat dengan kombinasi (p>0.05). Pada konsentrasi 10'5M, kombinasi SNAP dan sildenafil sitrat dapat merelaksasikan korpus kavernosum lebih baik dibandingkan dengan SNAP saja (p<0.05), namun tidak ada perbedaan bermakna antara kombinasi dengan sildenafil sitrat saja (p>0.05).Kesimpulan: kombinasi SNAP dan sildenafil sitrat pada konsentrasi tinggi memberikan hasil yang signifikan dibandingkan dengan SNAP saja. Tidak ada perbedaan yang signifikan bila dibandingkan dengan sildenafil sitrat saja.

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Introduction: Nitric oxide induces smooth muscle relaxation by causing an increase of cyclic guanosine monophosphate (cGMP) within the smooth muscle cell by stimulating guanylate cyclase. Sildenafil is a potent and selective inhibitor of cyclic-GMP-specific phosphodiesterase type V, the predominant isoenzyme metabolizing cyclic GMP in corpus cavernosum. Cyclic GMP is the second messenger of nitric oxide and a principal mediator of smooth muscle relaxation and vasodilatation in the penis.

Aim: The objective of this study was to compare the efficacy between nitric oxide donor, specific phosphodiesterase type V and its combination on the relaxation of rabbit corpus cavernosum.

Material and Methods: Isolated strips of rabbit corpus cavernosum were stimulated isometrically with phenylephrine. Graded relaxations were induced using various concentrations of S-Nitroso-N-acetylpenicillamine (SNAP), sildenafil citrate and its combination. Statistical significance was tested by the one way analysis of variance (ANOVA) and if there was a difference among the means, the test will be continued with a multiple comparissons of Benferroni.

Results: At 10-8 M, SNAP, sildenafil citrate and it's combination relaxed the preparation by 29 ± 4.8%, 46 + 2.5%, and 36 ± 3.9% respectively. The difference was significant by analisis of variance test (p<0.05). The same result was found at concentration 10'7M, 10-5M, and 10-5M concentration. From a multiple comparisson of Benferroni test, it was known that in concentration of 10-5M, 10' 'M, and10-6M the sildenafil citrate can relaxed the corpus cavernosum higher than SNAP (p<0.05) and there was no difference between sildenafil citrate and combination (p>0.05). In the concentration of 10"5M, the combination of SNAP and sildenafil citrate can relaxed the corpus cavernosum higher than SNAP alone significantly (p<0.05) but there was no significant difference between combination and sildenafil citrate (p>0.05).

Conclusions: Combination of SNAP and sildenafil citrate gave a significant result in a high concentration compared to SNAP alone but there were no significant difference compared to Sildenafil citrate alone."

"Objective: To examine the direct effect of type 5 phosphodiesterase inhibitor (sildenafil), nitric oxide-donor (sodium nitroprusside) and their combination on human spermatozoa in vitro.Method: Semen samples were collected by masturbation after 3 days of abstinence from donors presenting for infertility evaluation at Imunoendocrinology Labolatory. Samples were divided into normospermia and asthenospermia. Each group were washed on discontinuous density gradient (Percoll 45% and 90%) at 300g for 20 minutes, then resuspended in capacitation media containing Ham's F10. Aliquots of 10x106 spermatozoa were reacted with PDE5 inhibitor, NO-donor, their combination, and also Pentoxyphylline (non-selective PDE) in different doses (0.1,1 and 10 umol). Minimally 6 samples were test for each dose. After 1 hour incubation at 37°C, 5% CO2 in air, microscopic analyses were performed to count motility. Analysis of Variance (ANOVA) was used to test difference among the means.Result: There were 27 normospemia samples and 24 asthenospermia samples. In normopsermia group, Sildenafil, NO-donor and their combination increase spermatozoa motility significantly if compare to their blank (p 0.023,0.015,0.006). Sildenafil caused dose-dependent increase in spermatozoa motility. Low dose NO-donor increase motility. Combination of Sildenafil and NO-donor could not increase motility better than Sildenafil or NO-donor alone. Sildenafil or NO-donor increase motility higher than Pentoxyphylline. In asthenospermia group, Sildenafil, NO-donor, Sildenafil+NO-donor, and Pentoxyphylline increase motility compare to their blank, but there were no significant difference.Conclusion: Sildenafil, NO-donor and their combination increase spermatozoa motility significantly if compare to their blank. NO-donor could not enhance the effect of Sildenafil to increase motility."

"Gastroesophageal reflux disease (GERD) adalah suatu kondisi kembalinya cairan lambung ke esofagus. Terapi akupunktur tanam benang telah menjadi salah satu terapi yang digunakan untuk alternatif terapi. Penelitian ini bertujuan untuk mengetahui perubahan kadar Nitrit Oksida (NO) serum setelah terapi akupunktur tanam benang dan medikamentosa. Uji acak tersamar tunggal dilakukan pada 50 responden dengan GERD yang di bagi kepada kelompok akupunktur tanam benang dan medikamentosa dibandingkan dengan kelompok akupunktur sham dan medikamentosa. Pemeriksaan kadar NO menjadi parameter yang dinilai pada saat sebelum perlakuan dan 30 hari setelah 2 kali terapi dengan durasi 15 hari sekali.Hasil penelitian menunjukkan terjadi kenaikan kadar NO pada kelompok perlakuan dibandingkan kelompok sham namun tidak ada perbedaan bermakna antara kedua kelompok. Kesimpulan penelitian ini akupunktur tanam benang belum terbukti secara statistik mempengaruhi kadar NO pada pasien GERD.

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OksidaGastroesophageal reflux disease (GERD ) is a condition that causes the return of gastric fluid into the esophagus. Catgut embedding acupuncture has become one of the therapies used for alternative therapies. This study aimed to determine changes in serum Nitric Oxide (NO) levels after catgut embedding acupuncture therapy and conventional medicine. Single -blind randomized trials is used on 50 respondents with GERD were divided to group catgut embedding acupuncture therapy and conventional medicine compared with sham acupuncture group and medicine. The level of NO into the parameters assessed at the time before treatment and 30 days after treatment with 2 times the duration of 15 days.

The results showed increased levels of NO in catgut embedding acupuncture therapy and conventional medicine group compared with sham acupuncture group and medicine but there was no significant difference between the two groups. The conclusion of this study catgut embedding acupuncture has not been proven statistically in influencing the levels of NO in patients with GERD."

"[ABSTRAKLatar belakang: Hipertensi dan aterosklerosis berkaitan dengan disfungsi endotel yang ditandai oleh pengurangan produksi nitric oxide (NO) dan penurunan NO bioavailability. Disfungsi endotel dapat terjadi sejak usia anak-anak dan inaktivitas fisik menjadi faktor risiko penyakit kardiovaskular. Namun belum banyak penelitian mengenai perbedaan pengaruh latihan fisik aerobik pada juvenil dibandingkan dengan dewasa terhadap fungsi vaskular. Penelitian ini bertujuan untuk mengetahui pengaruh usia latihan fisik terhadap kadar NO, MDA dan aktivitas spesifik enzim SOD pada aorta abdominal dengan lama latihan yang sama.Metode: Subjek penelitian adalah tikus usia juvenil dan dewasa muda yang dibagi dalam kelompok latihan dan kontrol. Latihan aerobik selama 8 minggu menggunakan treadmill dengan kecepatan disesuaikan dengan usia tikus selama 20 menit intermitten, 5x seminggu. Analisis kadar NO, MDA dan aktivitas SOD aorta abdominal menggunakan uji t-test independen (data berdistribusi normal dan homogen) atau uji U-Mann Whitney (data tidak normal).Hasil: Kadar NO dan aktivitas spesisfik SOD lebih tinggi pada kelompok latihan dibandingkan kontrol, baik pada kelompok juvenil maupun dewasa muda. Namun hanya pada kelompok dewasa muda yang perbedaannya bermakna. Tidak terdapat perbedaan bermakna kadar MDA antara kelompok latihan dan kontrol pada kedua usia. Kadar MDA pada kelompok juvenil meningkat dan menurun pada kelompok dewasa muda akibat latihan aerobik selama 8 minggu.Kesimpulan: Latihan aerobik dapat meningkatkan produksi NO dan NO bioavailability pada kelompok juvenil maupun dewasa muda. Peningkatan NO bioavailability terjadi melalui aktivitas spesifik enzim SOD. Diduga tingginya kadar MDA pada kelompok latihan dan kontrol juvenil terkait dengan usia dan stres fisik. Belum diketahui apakah peningkatan kadar MDA pada kelompok juvenil masih dalam kisaran normal atau tidak. Oleh karena itu, masih terdapat beberapa pertanyaan terkait manfaat latihan pada juvenil.

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ABSTRACTBackground: Hypertension and atherosclerosis are related to endothelial dysfunction, that characterized with decrease of NO production and bioavailability. Physical inactivity has contribute to endothelial dysfunction that can occur since childhood. However, until now, there were only few studies about the difference effect of aerobic training to vascular function in juvenile and young-adult rats. Therefore, this study aimed to know the effect of age related- exercise training to level of NO, MDA and specific SOD activity in abdominal aorta.Methode: Subjects were juvenile and young adult male wistar rats divided into 2 group: control and aerobic training. Aerobic training performed in 8 weeks with animal treadmill with age-dependent speed for 20 minutes intermittent exercise, 5x per week. Analysis of NO, MDA level, and SOD activity of abdominal aorta used t-test independent (normal distribution and homogen) or U-Mann Whitney (not normal distribution)Results: NO level and SOD specific activity in training group were higher than control group, in both juvenile and young adult group. But, only in young adult group that had significant result. There was no significant different of MDA level in training group compared to control group in both juvenile and young-adult group, but MDA level increased in juvenile group and decreased in young-adult group because of aerobic training for 8 weeks.Conclussion: Aerobic training can increase NO production and bioavaibility both in juvenile and young adult group. Increase of NO bioavailability was considered to the increase of SOD specific activity. We considered that the increase of MDA level in training and control juvenile group were related to age and physical stress. We didn?t know yet the increased level of MDA in juvenile group was still in normal range level or not. Therefore is still any question if training in juvenile rat was benefit or not.;Background: Hypertension and atherosclerosis are related to endothelial dysfunction, that characterized with decrease of NO production and bioavailability. Physical inactivity has contribute to endothelial dysfunction that can occur since childhood. However, until now, there were only few studies about the difference effect of aerobic training to vascular function in juvenile and young-adult rats. Therefore, this study aimed to know the effect of age related- exercise training to level of NO, MDA and specific SOD activity in abdominal aorta.Methode: Subjects were juvenile and young adult male wistar rats divided into 2 group: control and aerobic training. Aerobic training performed in 8 weeks with animal treadmill with age-dependent speed for 20 minutes intermittent exercise, 5x per week. Analysis of NO, MDA level, and SOD activity of abdominal aorta used t-test independent (normal distribution and homogen) or U-Mann Whitney (not normal distribution)Results: NO level and SOD specific activity in training group were higher than control group, in both juvenile and young adult group. But, only in young adult group that had significant result. There was no significant different of MDA level in training group compared to control group in both juvenile and young-adult group, but MDA level increased in juvenile group and decreased in young-adult group because of aerobic training for 8 weeks.Conclussion: Aerobic training can increase NO production and bioavaibility both in juvenile and young adult group. Increase of NO bioavailability was considered to the increase of SOD specific activity. We considered that the increase of MDA level in training and control juvenile group were related to age and physical stress. We didn’t know yet the increased level of MDA in juvenile group was still in normal range level or not. Therefore is still any question if training in juvenile rat was benefit or not., Background: Hypertension and atherosclerosis are related to endothelial dysfunction, that characterized with decrease of NO production and bioavailability. Physical inactivity has contribute to endothelial dysfunction that can occur since childhood. However, until now, there were only few studies about the difference effect of aerobic training to vascular function in juvenile and young-adult rats. Therefore, this study aimed to know the effect of age related- exercise training to level of NO, MDA and specific SOD activity in abdominal aorta.Methode: Subjects were juvenile and young adult male wistar rats divided into 2 group: control and aerobic training. Aerobic training performed in 8 weeks with animal treadmill with age-dependent speed for 20 minutes intermittent exercise, 5x per week. Analysis of NO, MDA level, and SOD activity of abdominal aorta used t-test independent (normal distribution and homogen) or U-Mann Whitney (not normal distribution)Results: NO level and SOD specific activity in training group were higher than control group, in both juvenile and young adult group. But, only in young adult group that had significant result. There was no significant different of MDA level in training group compared to control group in both juvenile and young-adult group, but MDA level increased in juvenile group and decreased in young-adult group because of aerobic training for 8 weeks.Conclussion: Aerobic training can increase NO production and bioavaibility both in juvenile and young adult group. Increase of NO bioavailability was considered to the increase of SOD specific activity. We considered that the increase of MDA level in training and control juvenile group were related to age and physical stress. We didn’t know yet the increased level of MDA in juvenile group was still in normal range level or not. Therefore is still any question if training in juvenile rat was benefit or not.]"

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Gangguan tidur merupakan masalah yang umum terjadi pada pasien gagal jantung. Studi ini bertujuan untuk mengidentifikasi pengaruh penerapan sleep hygiene dan relaksasi Benson terhadap kualitas tidur pasien gagal jantung. Desain penelitian menggunakan kuasi eksperimen dengan pre dan post test. Tehnik pengambilan data menggunakan purposive sampling dan melibatkan 100 responden dengan New York Heart Association class II dan III. 50 responden pada kelompok intervensi dan 50 responden pada kelompok kontrol. Kombinasi Sleep hygiene dengan relaksasi Benson berpengaruh signifikan terhadap kualitas tidur, begitu pula relaksasi Benson berpengaruh signifikan terhadap kualitas tidur walaupun skor kualitas tidur masih buruk. Pada penelitian ini terdapat perbedaan bermakna antara skor kualitas tidur setelah perlakuan pada kelompok intervensi dibandingkan kelompok kontrol (p= 0,000, I±= 0,05).

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Sleep disturbance is a common problem in heart failure patients. The aim of current study was to evaluate the effect of sleep hygiene and Benson relaxation on the sleep quality among heart failure patients. The design of this study used quasi-experiment with pre and post test. This study used a purposive sampling and involved 100 respondents with New York Heart Association class II and III. 50 respondents in the intervention group and 50 respondents in the control group. The combination of Sleep hygiene and Benson relaxation had a significant effect on sleep quality, as well as Benson relaxation had a significant effect on sleep quality even though sleep quality scores were still poor. In this study there were significant differences between sleep quality scores after treatment in the intervention group compared to the control group (p = 0,000, I± = 0.05).

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"Praktik keperawatan residensi yang dilakukan di Rumah Sakit Persahabatan dengan kekhususan respirasi diharapkan dapat mengatasi masalah pernapasan. Selama menjalani proses residensi, residen berperan menjadi seorang Clinical Care Manajer (CCM) yang bertugas sebagai konsultan keperawatan bagi staf keperawatan dan pemberi terapi keperawatan kepada pasien, sebagai peneliti dan pendidik dalam rangka pemberi asuhan keperawatan untuk meningkatkan mutu atau kualitas asuhan keperawatan. Dalam memberikan asuhan keperawatan pada kasus kelolaan pasien dengan kanker paru dan 30 kasus resume menggunakan teori Henderson 14 kebutuhan dasar manusia yang menunjukkan peran perawat sebagai pemberi asuhan keperawatan dalam membantu individu baik dalam keadaan sehat maupun sakit, melalui usahanya melakukan berbagai aktivitas guna mendukung kesehatan dan penyembuhan individu atau proses meninggal dengan damai. Masalah keperawatan yang banyak muncul yaitu tentang pemenuhan kebutuhan bernapas normal. Penerapan EBN kombinasi latihan pursed lip breathing dan progressive muscle relaxation terhadap penurunan dyspnea pada pasien PPOK. Pelaksanaan proyek inovasi video sebagai program peningkatan kemampuan perawat dalam melakukan monitoring terhadap pasien yang terpasang Water Seal Drainage (WSD) dan pemberian edukasi kepada pasien yang terpasang WSD di rumah. Hasil analisis praktik residensi keperawatan didapatkan bahwa asuhan keperawatan menggunakan pendekatan teori Henderson bertujuan untuk membantu sesegera mungkin kemandirian pasien. Penerapan kombinasi latihan pursed lip breathing dan progressive muscle relaxation dapat menurunkan dyspnea pada pasien PPOK. Proyek inovasi program peningkatan kemampuan perawat dalam melakukan monitoring WSD dan pemberian edukasi dirumah pada pasien yang terpasang WSD dengan media video dapat meningkatkan kemampuan perawat dalam melakukan monitoring WSD secara sistematis dan terstruktur dan kemampuan melakukan edukasi dirumah pada pasien.

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Residency nursing practice carried out at Persahabatan Hospital with the speciality of respiration was expected to overcome respiratory problems. In addition, during the residency process, the resident perform the role to become a clinical care manager (CCM) who serves as a nursing consultant for nursing staff and nursing therapy providers to patients, researches and educator in the context of providing nursing care to improve the quality of nursing care. In providing nursing care in managed cases of patients with lung cancer and 30 resumed cases used Henderson's theory of 14 basic human needs which showed the role of nurses as nursing care providers in helping individuals both in health and illness, through their efforts to carried out various activities to support individual health and healing or the process of dying peacefully. Many nursing problems that arise were about fulfilling normal breathing needs. Application of EBN combination of pursed lip breathing exercises and progressive muscle relaxation to reduce dyspnea in COPD patients. The implementation of the video innovation project as a program to improve the ability of nurses to monitor patients with watered seal drainage (WSD) and provided education to patients with WSD at home. The results of the analysis of nursing residency practice found that nursing care used the Henderson theory approach aims to help the patient's independence as soon as possible. The application of a combination of progressive muscle relaxation and pursed lip breathing exercises could reduce dyspnea in COPD patients. The program innovation project to improve nurses' ability to monitor WSD and provided home education to patients with WSD installed with video media could improve nurses' ability to monitor WSD systematically and structured and the ability to educate patients at home Keywords: nursing specialist, lung cancer, Henderson nursing theory"

"Latar belakang : Asma memengaruhi sekitar 300 juta orang di seluruh dunia dan menjadi masalah kesehatan global yang serius yang mempengaruhi semua kelompok umur. Asma alergi adalah fenotipe asma yang paling mudah dikenali dan sering dimulai sejak masa anak-anak. Sebagian besar asma alergi berhubungan dengan sensitisasi saluran napas akibat pajanan aeroalergen umum, terutama yang berasal dari tungau debu rumah. Proses inflamasi eosinofilik saluran napas menghasilkan produk akhir berupa nitrit oksida. Kadar nitrit oksida udara ekspirasi (FeNO) merupakan salah satu penanda hayati yang mengukur inflamasi saluran napas dan kadar FeNO yang tinggi pada pasien asma berhubungan dengan inflamasi saluran napas eosinofilik.Penilitian ini bertujuan mengetahui hubungan kadar IgE spesifik Der p dan Der f  dengan kadar FeNO pada pasien asma tidak terkontrol di RSUP Persahabatan.Metode : Penelitian ini merupakan studi potong lintang dengan jumlah sampel 86 subjek pasien asma tidak terkontrol berdasarkan asthma control test di RSUP Persahabatan. Metode pengumpulan subjek dilakukan dengan teknik consecutive sampling. Pemeriksaan IgE spesifik tungau debu rumah menggunakan protia Q96M. Pemeriksaan FeNO menggunakan Bedfont NObreath.Hasil : Dari 86 subjek asma tidak terkontrol didapatkan hasil rerata usia pasien asma tidak terkontrol di RSUP Persahabatan adalah  52,45 + 12,94 tahun, sebagian besar berjenis kelamin perempuan (84,9%).Proporsi pasien asma yang alergi terhadap tungau debu rumah  mencapai 64%. Prorporsi alergi Der p dan Der f 58%, alergi Der p 4,7% dan alergi Der f 1,2%. Median kadar IgE spesifik tungau debu rumah pada pasien asma tidak terkontrol di RSUP Persahabatan adalah 3,94 (0-100) IU/ml untuk Der p dan 4,47 (0-100) IU/ml untuk Der f. Median FeNO pasien asma tidak terkontrol adalah 26 (3-92) ppb. Dilakukan uji korelasi Spearman untuk kadar IgE spesifik dan kadar FeNO pasien asma tidak terkontrol. Terdapat hubungan bermakna antara kadar IgE spesifik Der p (nilai p = 0,009, r = 0,279, uji Spearman) dan Der f (nilai p = 0,001, r = 0,339, uji Spearman) dengan FeNO.Kesimpulan : Terdapat hubungan yang bermakna antara kadar IgE spesifik tungau debu rumah Der p dan Der f dengan FeNO pada pasien asma tidak terkontrol. Namun tingkat korelasi yang didapatkan lemah.

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Background : Asthma affects approximately 300 million people worldwide and is a serious global health problem affecting all age groups. Allergic asthma is the most easily recognized asthma phenotype and often begins in childhood. Most allergic asthma is associated with airway sensitization due to exposure to common aeroallergens, particularly those from house dust mites. The eosinophilic inflammatory process of the airways produces the final product in the form of nitric oxide. Fractional exhaled nitric oxide (FeNO) levels are one of the biomarkers that measure airway inflammation and high FeNO levels in asthma patients are associated with eosinophilic airway inflammation. This study aims to determine the relationship between Dermatophagoides pteronysinnus (Der p) and Dermatophagoides  farinae (Der f) specific IgE levels with FeNO levels in uncontrolled asthma patients at Persahabatan Hospital.

Method : This cross sectional study in 86 uncontrolled asthma patients based on asthma control test less than 24 points. The method of collecting subjects was done by consecutive sampling technique. House dust mite specific IgE assay using protia Q96M. FeNO examination using Bedfont NObreath.   

Result : From 86 subjects with uncontrolled asthma, the mean age of uncontrolled asthma patients at Persahabatan Hospital was 52.45 + 12.94 years, most of them were female (84.9%). The proportion of asthma patients who were allergic to house dust mites reached 64. %. The proportion of allergy to Der p and Der f 58%, allergy to Der p 4.7% and allergy to Der f 1.2%. The median level of specific IgE for house dust mites in patients with uncontrolled asthma at the Persahbatan Hospital was 3.94 (0-100) IU/ml for Der p and 4.47 (0-100) IU/ml for Der f. The median FeNO of uncontrolled asthmatic patients was 26 (3-92) ppb. Spearman correlation test was performed for specific IgE levels and FeNO levels in patients with uncontrolled asthma. There was a significant relationship between specific IgE levels Der p (p value = 0.009, r = 0.279) and Der f (p value = 0.001, r = 0.339) and FeNO.

Conclusion : There is a significant relationship between the levels of specific IgE for house dust mites Der p and Der f with FeNO in patients with uncontrolled asthma. However, the correlation level obtained is weak."

"[ABSTRAKPendahuluan: Tatalaksana osteomielitis dengan debridement, guttering, pemberian antibiotika sistemik sering tidak mencapai hasil yang memuaskan dikarenakan antibiotik tidak dapat mencapai lokasi infeksi dengan baik. Cara lain dengan pemberian antibiotik lokal untuk mencapai lokasi infeksi dalam bentuk beads dinilai tidak efektif karena memerlukan 2 kali operasi. Kombinasi antibiotik lokal dengan scaffolding berupa hidroxyapatite (HA) porous yang dapat diserap dan pembawa antibiotik belum pernah diteliti.Metode penelitian: Dilakukan uji pre test post test kelompok kontrol pada model kelinci osteomielitis. Sepuluh ekor kelinci New Zealand digunakan dengan berat 2.500-3500 gr yang dibagi kedalam 2 kelompok yaitu kelompok kontrol dan kelompok perlakuan (n=5). Dilakukan penyuntikan bakteripada tulang tibia kelinci, setelah terbentuk model osteomielitis kemudian dilakukan perlakuan. Untuk kelompok kontrol dilakukan debridement dan diberikan injeksi antibiotik ceftriaxon selama 4 minggu dan kelompok perlakuan dilakukan debridement, diberikan kombinasi HA dan Gentamisin serta injeksi antibiotik ceftriaxon selama 4 minggu. Setelahnya dilakukan penilaian klinis, x- ray, kultur dan histopatologis.Temuan dan Diskusi: Secara radiologis ditemukan perbaikan skor penebalan kortek tibia pada kelompok perlakuan dibanding kelompok kontrol (p=0.48), begitu juga pada Histopatological osteomyelitis evaluation score (p=0,009). Secara klinis terdapat perbaikan skor pembengkakan pada semua (n=5) kelompok perlakuan dibanding dengan kelompok kontrol, namun secara statistik tidak bermakna (p=0,053). Sementara pada penilaian kultur tidak ditemukan perbedaan bermakna antar kedua kelompok (p=1,00)Kesimpulan: Kombinasi Hydroxyapaptite porous dan gentamisin sebagai antibiotik lokal pada pengobatan model osteomielitis tibia kelinci memberikan perbaikan skor radiologis, histopatologis dan perbaikan klinis dibanding dengan prosedur standar pengobatan oseomielitis kronis yang sudah ada.

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ABSTRACTIntroduction. Treatment of osteomyelitis with debridement, guttering, systemic antibiotics often do not achieve satisfactory results due to the antibiotic can not reach the infection site. Another way of local antibiotic delivery to reach the site of infection in the form of beads is considered ineffective because it requires two separate surgeries. Local antibiotic combined with scaffold in the form of porous hidroxyapatite that can be absorbed and antibiotics cariere have not been studied.Methods. We conducted pretest and posttest control group in a rabbit model of osteomyelitis. Ten rabbits divided in control group and the treatment group (n=5). We injected Staphylococcus aureus in the rabbit tibia, forming the osteomyelitis model, and then performed treatment for osteomyelitis. In the control group, we performed debridement and gave ceftriaxone injection for 4 weeks. Whereas in the treatment group, we add the combination of porous hidroxyapatite and Gentamicin. Afterwards, we did clinical assessment, x-ray, culture, and histopathology.Results and discussion. Radiologically, tibia cortical thickening scores improved in the treatment group compared to the control group (p=0.48) as well as histopatological osteomyelitis evaluation score (p=0,009). Clinically, there were improvements in the swelling scores (n=5) of the treatment group compared to control group, but no significant statistically (p=0.053). In culture, there were no significant difference between the two groups (p=1.00).Conclusion. Combination of porous hydroxyapaptite and gentamycin as a local treatment of osteomyelitis of the rabbit tibial osteomyelitis models improved radiological and histopathological scores and also clinically compared to existing standard treatment procedures for chronic osteomyelitis., Introduction. Treatment of osteomyelitis with debridement, guttering, systemic antibiotics often do not achieve satisfactory results due to the antibiotic can not reach the infection site. Another way of local antibiotic delivery to reach the site of infection in the form of beads is considered ineffective because it requires two separate surgeries. Local antibiotic combined with scaffold in the form of porous hidroxyapatite that can be absorbed and antibiotics cariere have not been studied.Methods. We conducted pretest and posttest control group in a rabbit model of osteomyelitis. Ten rabbits divided in control group and the treatment group (n=5). We injected Staphylococcus aureus in the rabbit tibia, forming the osteomyelitis model, and then performed treatment for osteomyelitis. In the control group, we performed debridement and gave ceftriaxone injection for 4 weeks. Whereas in the treatment group, we add the combination of porous hidroxyapatite and Gentamicin. Afterwards, we did clinical assessment, x-ray, culture, and histopathology.Results and discussion. Radiologically, tibia cortical thickening scores improved in the treatment group compared to the control group (p=0.48) as well as histopatological osteomyelitis evaluation score (p=0,009). Clinically, there were improvements in the swelling scores (n=5) of the treatment group compared to control group, but no significant statistically (p=0.053). In culture, there were no significant difference between the two groups (p=1.00).Conclusion. Combination of porous hydroxyapaptite and gentamycin as a local treatment of osteomyelitis of the rabbit tibial osteomyelitis models improved radiological and histopathological scores and also clinically compared to existing standard treatment procedures for chronic osteomyelitis.]"

"Ksantorizol merupakan salah satu senyawa yang mempunyai aktivitas sebagai antiinflamasi. Penelitian ini bertujuan melakukan sintesis dan uji aktivitas derivat ksantorizol sebagai inhibitor produksi nitrit oksida (NO) pada sel RAW 264,7. Sebanyak empat senyawa derivat ksantorizol telah berhasil disintesis dan dikarakterisasi menggunakan FTIR, NMR dan HR-MS serta dilakukan uji aktivitas penghambatan NO menggunakan sel RAW 264,7 yang telah distimulasi menggunakan LPS. Esterifikasi ksantorizol (senyawa 1) dilakukan pada tahap pertama menghasilkan senyawa 2a dan gugus senyawa 2b dengan rendemen hasil sintesis masing-masing sebesar 58,49 % dan 63.2%. Selanjutnya senyawa 2a dan 2b dioksidasi menggunakan kalium permanganat menjadi senyawa 3a dan 3b dengan rendemen masing-masing 51,92% dan 43,78%. Hasil uji senyawa 1 ,2a ,3a, 3b dan sodium diklofenak sebagai kontrol positif masing-masing mempunyai nilai IC50 penghambatan produksi NO sebesar 31,82; 73,85; 354,05; 97,19; dan 78,43 µM, sedangkan untuk senyawa 2b tidak menunjukkan aktivitas terhadap penghambatan produksi NO. Uji sitotoksisitas senyawa 1 ,2a ,2b ,3a, 3b dan sodium diklofenak mempunyai nilai LD50 sebesar 30,97; 65,15; 31,15; 117,86; 53,40; dan 51,67 µM. Senyawa 2a, 3a, dan 3b aktivitasnya lebih rendah untuk menghambat produksi NO ketika dibandingkan ksantorizol (senyawa 1). Hasil uji sitotoksisitas menunjukkan senyawa 2a, 3a dan 3b mempunyai toksisitas lebih rendah dibandingkan dengan ksantorizol.

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Xanthorrhizol is one of the compounds as anti-inflammatory activity. This experiment aimed were to synthesize xanthorrhizols derivate and examine their activity as inhibitory of nitric oxide (NO) production. Thus, four derivatives of xanthorrhizol were synthesized and characterized using FTIR, 1H-NMR and 12C-NMR, HR-MS, as well as investigated their anti-inflammatory activity using RAW 264.7 macrophage cells LPS induced. The first stage of synthesis produced compounds, namely 2a and 2b yielding 58, 49 % and 63,26%, respectively. Furthermore, compounds 2a and 2b were oxidised using potassium permanganate, constructing compounds 3a and 3b yielding 51,92% and 43,78, respectively. The result revealed that compound 1, 2a, 3a, and 3b as well as diclofenac sodium, a positive control, had IC50 values of NO production, showing 31,82, 73,85, 354,05, 97,19 and 78,43 M, respectively. While for compound 2b, it didnt show activity. Cytotoxicity assay of compounds 1, 2a, 2b, 3a, 3b, and diclofenac sodium pointed the LD50 values, resulting 30,97, 65,15, 31,15, 117,86, 53,40, and 51,67 µM, respectively. Compound 2a, 3a and 3b showed lesser activity to inhibit NO production when compared with xanthorrhizol (compound 1). The result of the cytotoxicity tests implicated that compound 2a, 3a and 3b had a lower activity than xanthorrhizol. "